Reducing Racial Disparities in Caregiver Presence During Family-Centered Rounds.

Area of Science:

• Healthcare quality improvement
• Health equity in pediatrics
• Patient and family engagement

Background:

• Family-centered rounds (FCR) are crucial for patient care, but disparities exist in caregiver participation.
• Caregivers of Black patients historically had lower physical presence during FCR compared to white patients (72.2% vs. 81.8%).
• Addressing these disparities is essential for equitable healthcare delivery.

Purpose of the Study:

• To increase the presence of caregivers (physical or telephone) for Black patients during hospital medicine (HM) FCR.
• To reduce the racial gap in caregiver participation in FCR.
• Targeted a 10.8% increase for Black patients' caregivers, from 72.2% to 83% within five months.

Main Methods:

• A quality improvement initiative was implemented at a large urban children's hospital.
• Key drivers included early identification of Black patients and addressing communication barriers.
• Plan-do-study-act cycles were used, tracking caregiver presence disaggregated by race via run and control charts.

Main Results:

• Over 15 months, caregiver presence increased to 81.7% for Black patients and 85.2% for white patients.
• Initial improvements were not sustained, necessitating further interventions.
• Successful reimprovement was achieved by discussing caregiver preferences at admission and calling non-present caregivers.

Conclusions:

• The quality improvement initiative successfully enhanced caregiver presence during FCR.
• The interventions significantly decreased the racial disparity in caregiver participation.
• This demonstrates the effectiveness of targeted strategies in promoting health equity.